Provider Demographics
NPI:1629066121
Name:EASTERN CAROLINA PATHOLOGY INC
Entity Type:Organization
Organization Name:EASTERN CAROLINA PATHOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:CASH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-399-8156
Mailing Address - Street 1:PO BOX 3789
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24115-3789
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2693 FOREST HILLS RD SW STE B
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-8611
Practice Address - Country:US
Practice Address - Phone:252-234-9176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0155YOtherBCBS OF NC
202117OtherMEDCOST
NC7001152Medicaid
202117OtherMEDCOST